Korean J Radiol.  2017 ;18(4):691-698. 10.3348/kjr.2017.18.4.691.

Texture Analysis of Torn Rotator Cuff on Preoperative Magnetic Resonance Arthrography as a Predictor of Postoperative Tendon Status

• Kang Y
• Lee GY
• Lee JW
• Lee E
• Kim B
• Kim SJ
• Ahn JM
• Kang HS

• KMID: 2427238
• DOI: http://doi.org/10.3348/kjr.2017.18.4.691

Abstract

OBJECTIVE
To evaluate texture data of the torn supraspinatus tendon (SST) on preoperative T2-weighted magnetic resonance arthrography (MRA) using the gray-level co-occurrence matrix (GLCM) for prediction of post-operative tendon state.
MATERIALS AND METHODS
Fifty patients who underwent arthroscopic rotator cuff repair for full-thickness tears of the SST were included in this retrospective study. Based on 1-year follow-up, magnetic resonance imaging showed that 30 patients had intact SSTs, and 20 had rotator cuff retears. Using GLCM, two radiologists measured independantly the highest signal intensity area of the distal end of the torn SST on preoperative T2-weighted MRA, which were compared between two groups.The relationships with other well-known prognostic factors, including age, tear size (anteroposterior dimension), retraction size (mediolateral tear length), grade of fatty degeneration of the SST and infraspinatus tendon, and arthroscopic fixation technique (single or double row), also were evaluated.
RESULTS
Of all the GLCM features, the retear group showed significantly higher entropy (p < 0.001 and p = 0.001), variance (p = 0.030 and 0.011), and contrast (p = 0.033 and 0.012), but lower angular second moment (p < 0.001 and p = 0.002) and inverse difference moment (p = 0.027 and 0.027), as well as larger tear size (p = 0.001) and retraction size (p = 0.002) than the intact group. Retraction size (odds ratio [OR] = 3.053) and entropy (OR = 17.095) were significant predictors.
CONCLUSION
Texture analysis of torn SSTs on preoperative T2-weighted MRA using the GLCM may be helpful to predict postoperative tendon state after rotator cuff repair.

Keyword

Rotator cuff; Shoulder joint; Magnetic resonance imaging; Texture analysis; Statistical data analyses

MeSH Terms

Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
*Magnetic Resonance Imaging
Male
Middle Aged
Predictive Value of Tests
Preoperative Period
Retrospective Studies
Rotator Cuff Injuries/pathology/*surgery
Tendons/*diagnostic imaging
Treatment Outcome

Figure

• 

  Fig. 1 GLCM program.Texture analysis of T2-weighted coronal images using gray-level co-occurrence matrix software package. GLCM = graylevel co-occurrence matrix

• 

  Fig. 2 70-year-old female with retear shows high entropy value measured by GLCM.A. Small-sized rim-rent tear of supraspinatus tendon is identified at greater tuberosity in 70-year-old woman on T2-weighted coronal image of right shoulder MRI (arrow), which has high entropy value measured by GLCM. B. One year later, she has retear of supraspinatus tendon (arrow) with large retraction from anchor of rotator cuff repair (dashed arrow) on postoperative MRI. GLCM = gray-level co-occurrence matrix

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